An Era of Greater Accountability

The amount of documentation and general paperwork required for third-party reimbursement has reached a level bordering on insanity. DCs are required to spend $8 in staff time to fill out the forms necessary for the $15 the managed care company might eventually pay for care that is worth far more.

This sad state of affairs is the response to health care costs that have reached crisis proportions. Many employers can't afford to offer health care coverage and employees are horrified at the potential cost of a major accident or illness. Many retired people are afraid to live the good life they had planned, for fear of what the health care may cost them as they get older.

At the end of the day, society and politicians are trying to make everyone in the health care arena more accountable for the billions of dollars Americans spend for health - in spite of the fact that health care in the United States is considered inferior to that in many other Western countries.

You have undoubtedly experienced a similar feeling in your own practice. You watch every penny that goes out, because it is harder to get paid for what you do. Without a higher level of accountability, your practice would be much less profitable.

When you apply the concept of accountability to our national and state associations, we see a different dynamic at work. Instead of making them more accountable for how they spend your dues money (and money from other sources of income), you often vote with your feet. You decide if you are getting your money's worth from your association and generally make your buying decision based on benefits, protection and/or a sense of loyalty. When your association stops meeting your needs/expectations, you stop being a member.

Sadly, dropping your association membership doesn't keep the leadership and staff accountable. It really sends the opposite message. You are basically telling your association to stop listening to you and to listen to the remaining members instead.

It's undeniable that what the chiropractic profession needs is more accountability, not less.

We need all of the players in chiropractic - associations, colleges, organizations, companies and even publications - to set higher standards for themselves and be more responsive to the needs of practicing DCs and their patients. Leaders must be forthcoming and honest when it comes to their actions and motives. Associations that trade "endorsements" for kickbacks/commissions and other forms of payments need to seriously consider if they are truly in a position to endorse products objectively. (Why is it that I never see an association endorse a product it isn't getting paid to endorse?)

Everyone needs to be more aware of the fact that, like it or not, we represent chiropractic. Each of us, each day, does things that will either enhance chiropractic's image or tarnish it.

In many ways, chiropractic is fighting for its future, and it's time that all chiropractors, and all chiropractic organizations and entities, recognized the seriousness of our circumstances.

There is no place for self-dealing, underhanded politics and substandard performance. Leaders who focus on keeping their power and position, rather than working to accomplish what the profession needs, have no place in chiropractic today. Controlling an election is not the sign of a good leader.

If chiropractic is ever going to reach its potential, it will do so by self-sacrifice and accountability. We must expect more from ourselves, our organizations and our leaders. We have much to gain and much to lose.

DMP Jr.